Healthcare Provider Details

I. General information

NPI: 1669130936
Provider Name (Legal Business Name): SIG1,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6758 WILDLIFE RD
MALIBU CA
90265-4305
US

IV. Provider business mailing address

7 W FIGUEROA ST STE 300
SANTA BARBARA CA
93101-3189
US

V. Phone/Fax

Practice location:
  • Phone: 805-912-6363
  • Fax:
Mailing address:
  • Phone: 805-912-6363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DIANE FLINN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 805-912-6363